AUTHOR=Zhang Lilong , Jin Qi , Chai Dongqi , Kuang Tianrui , Li Chunlei , Guan Yongjun , Liu Li , Wang Weixing , Deng Wenhong 

TITLE=The correlation between probiotic use and outcomes of cancer patients treated with immune checkpoint inhibitors

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.937874

DOI=10.3389/fphar.2022.937874

ISSN=1663-9812

ABSTRACT=<p><bold>Objective:</bold> Immune checkpoint inhibitors (ICIs) have recently demonstrated promising results in improving the prognosis of cancer patients. The goal of this meta-analysis was to determine the impact of probiotic use on the survival of cancer patients treated with ICIs.</p><p><bold>Methods:</bold> Before 3 March 2022, the eligible literature was searched using PubMed, EMBASE, Cochrane Library, Google Scholar, and Clinical trials.gov databases. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) were the primary endpoints.</p><p><bold>Results:</bold> A total of 6 studies met the inclusion criteria, and 1,123 patients were included. Meta-analysis showed a trend for probiotic use to prolong PFS (HR: 0.585, 95% CI: 0.328–1.045, <italic>p</italic> = 0.070) and increase DCR (HR: 1.868, 95% CI: 0.890–3.922, <italic>p</italic> = 0.099), although it was of borderline statistical significance. We also found that probiotics significantly improved OS (HR: 0.526, 95% CI: 0.341–0.812, <italic>p</italic> = 0.004) and ORR (OR: 2.831, 95% CI: 1.578–5.076, <italic>p</italic> &lt; 0.001) in ICI-treated cancer patients. Besides, subgroup analysis showed that non-small cell lung cancer (NSCLC) patients treated with ICIs in combination with probiotics would achieve significantly longer PFS (HR: 0.532, 95% CI: 0.354–0.798, <italic>p</italic> = 0.002) and OS (HR: 0.528, 95% CI: 0.306–0.912, <italic>p</italic> = 0.022), as well as higher ORR (OR: 2.552, 95% CI: 1.279–5.091, <italic>p</italic> = 0.008) and DCR (OR: 2.439, 95% CI: 1.534–3.878, <italic>p</italic> &lt; 0.001). Sensitivity analysis showed that the above results are stable and reliable. The publication bias test confirmed that there was no publication bias in these results.</p><p><bold>Conclusion:</bold> Current evidence reveals that probiotics can improve the efficacy of ICI treatment in NSCLC patients.</p><p><bold>Systematic Review Registeration:</bold><ext-link ext-link-type="uri" xlink:href="https://www.crd.york.ac.uk/prospero/" xmlns:xlink="http://www.w3.org/1999/xlink">https://www.crd.york.ac.uk/prospero/</ext-link>, identifier CRD42022316104.</p>